Table 1.
Key epidemiology, clinical features, and risk factors of patients diagnosed with spontaneous coronary artery dissection (SCAD) or aortic dissection (AD)
| SCAD | AD | |
|---|---|---|
| Estimated prevalence | 1%–4% of all acute coronary syndrome cases | 4.4 per 100 000 person yearsa |
| Mortality | Lowb | 21.3 per 1 millionc |
| Sex | ||
| Women (overall) | ↑ | ↓ |
| Early-to-middle adulthood | ↑ | ↓ |
| Middle-to-late adulthood | ↓ | ↑ |
| Men (overall) | ↓ | ↑ |
| Early-to-middle adulthood | ↓ | ↓ |
| Middle-to-late adulthood | ↓ | ↑ |
| Predisposing risk factors | ||
| Pregnancy/postpartum/pre-eclampsia | ++ | ++ |
| Fibromuscular dysplasia | ++ | |
| Genetics/connective tissue disorders | ++ | ++ |
| Autoimmune/inflammatory diseases | ++ | ++ |
| Sex hormone disruptions/therapy | ++ | |
| Stimulating risk factors | ||
| Extreme/severe intensity exercise | ++ | ++ |
| Extreme/severe intensity physical activity | ++ | ++ |
| Extreme/severe physical torque movements | ++ | ++ |
| Intense psychological stress | ++ | ++ |
| Excessive Valsalva engagement | ++ | ++ |
| Recreational amphetamine use | ++ | ++ |
| Cardiovascular risk factors | ||
| Atherosclerosis | + | ++ |
| Hypertension | + | ++ |
| Dyslipidemia | + | ++ |
| Smoker/ex-smoker | + | ++ |
| Type II diabetes | + | + |
| Overweight/obese | + | ++ |
a
Overall age- and sex-adjusted incidence 1995 to 2015 (DeMartino et al.27).
b
In-hospital and 30-day outcomes, 1 death reported out of 750 cases (Saw et al.28). Overall mortality rate among all patients in the general population uncertain.
c
Overall age-adjusted mortality rate in 2019 (Nazir et al.24).
+Unlikely causative associations.
++Reported among case/observational data and current expert opinion suggests either known associations or possible associations of high clinical/research interest among patients.
↑ More likely to be observed among patients.
↓ Less likely to be observed among patients.